Database

This report of a public meeting involving officials, academics and campaigners. Evidence from: HSC/DETR At-work Road Safety Conference. The Barbican, London. 5th April 2001. Campaigners are intent on blurring the distinction between Motor and EL insurance when the driver or passengers are “at work”. The Radar report is available to subscribers: 1#4 1

Evidence from: Andrew@reliabilityoxford.co.uk Bias is a term that is commonly referred to in epidemiological studies. It is a technical term and does not imply a partisan desire for or attempt to produce a particular outcome. Bias is simply any factor that can distort the outcome of epidemiological work from its true value. There are a number of types of bias to consider: • failure to record or identify factors (confounders) that could result in the same effect or prevent the effect of the causal hypothesis under study. • inappropriate selection of study population. • diagnostic and exposure measurement techniques can be under or over sensitive, under or over specific and plain wrong. • measurements may be systematically biased. For example, an observer may improve in the accuracy of his observations with practice. If more cases than controls are observed at the beginning of the study, the results could be biased. Bias is particularly likely in studies that rely on exposure memory and/

The research explores how well the validity questionnaire can distinguish between those who intend to deceive and those who do not. Evidence from: BE McGuire et al. Journal of Clinical Psychology Mar (2001) Vol.57 #3 P401 A key issue in the design of validity questionnaires is whether they will work for specific claimant groups. This is especially pertinent when the illness itself is subjective. The Radar report is available to subscribers: 1#3 10

This editorial suggests a strong case for a specific identifiable cause of vCJD in Queeniborough. Evidence from: H Ashraf. Lancet March (2001) Vol. 357 #9620 p. 937. Five cases of confirmed new-variant CJD have occurred in a geographically small area in Leicestershire. The cases were included in a case control study which established a relative risk of 15 if you purchased and consumed beef from at least one of two butchers who, as standard practice, removed cow brains. Statistical significance was not recorded. Comment Clustering of cases will occur by chance, but the existence of a plausible link between cases reduces the credibility of this alternative explanation. The plausible link is founded on the memory of food purchasing and consumption habits over 20-year period. Victims and controls in the study were not equivalent. 9% of butchers (UK) practiced brain removal during the 80’s (no information available for the early nineties when exposure probably peaked). Slaughtering practice

Many insurers and HSE have been advised by Professor Tom Cox on the subject of stress at work. He has been a leading light behind the development of insight, guidance and standards in this field. He is soon to retire from his main post in Nottingham, but will be following two new ones! http://proftcox.wordpress.com/      

Evidence from: Thorax. April (2001) Vol.56 #4 p.251. A statement made by the British Thoracic Society covering diagnosis, cause and treatment for mesothelioma. The briefest highlights are reported here. Causation: • 1 in 10,000 cases are truly spontaneous. • Erionite also causes it. • Simian (SV(40)) virus has been proposed but not strongly supported. • Most cases are caused by asbestos. • In subjects heavily exposed to asbestos early in life more than 10% may die of mesothelioma. Relative Risk: Blue and brown asbestos are the most potent. Levels in well-maintained buildings are a small risk. Latency: From first exposure, to death has a mean of 41 years, rarely less than 15 years. Prognosis: Survival 8 – 14 months from diagnosis. Diagnosis: Occupational history is a key factor in diagnosis. The statement also includes advice on making an insurance claim for pleural mesothelioma! Comment Many of these views are well supported by published evidence.